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H5434 · Florida Blue (BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.): 2027 Star Rating
H5434 (Florida Blue, BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.) earned 3.0 stars in the 2027 Medicare Advantage Star Ratings, down from 3.5 in 2026. Parent company: Guidewell Mutual Holding Corporation. Plan type: Local CCP.
2027 overall CMS
3.0
Part C 3.0 · Part D 3.0
2026 overall CMS
3.5
Part C 3.5 · Part D 3.5
Change Calc
-0.5
2027 vs 2026
Members Calc
61,305
CMS county files, October 2026
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What stands out for H5434
- Most of its members are in Florida (61,305, 2.2% of Medicare Advantage members in CMS county files there). Calc
- Of the 36 rated contracts with members in Florida, 32 have a higher 2027 rating and 2 have the same rating. Calc
- Largest other contract in Florida: H1036 · Humana, 4.5 stars, 541,186 members. Calc
- At 3.0 stars it is below the 4-star line that sets 2028 quality bonus payments. CMS rule
- 6 of its 42 rated measures are at 5 stars; 17 are at 1 or 2 stars. Calc
Weakest high-weight measures
Measures with weight 2 or more and the lowest stars. These move the overall rating most.
- Health Plan Quality Improvement (C29, weight ×5): 2 stars
- Controlling High Blood Pressure (C14, weight ×3): 2 stars, score 77
- Medication Adherence for Diabetes Medications (D08, weight ×3): 2 stars, score 87
- Medication Adherence for Cholesterol (Statins) (D10, weight ×3): 2 stars, score 87
- Customer Service (C23, weight ×2): 2 stars, score 88
All 2027 measure scores Sourced: CMS
| Measure | Weight | Score | Stars |
|---|---|---|---|
| Breast Cancer Screening (C01) | ×1 | 77 | 4 |
| Colorectal Cancer Screening (C02) | ×1 | 75 | 4 |
| Annual Flu Vaccine (C03) | ×1 | 60 | 2 |
| Improving or Maintaining Physical Health (C04) | ×3 | 80 | 5 |
| Improving or Maintaining Mental Health (C05) | ×3 | 84 | 3 |
| Monitoring Physical Activity (C06) | ×1 | 54 | 4 |
| Osteoporosis Management in Women who had a Fracture (C10) | ×1 | 33 | 2 |
| Diabetes Care - Eye Exam (C11) | ×1 | 67 | 2 |
| Diabetes Care - Blood Sugar Controlled (C12) | ×3 | 86 | 3 |
| Kidney Health Evaluation for Patients with Diabetes (C13) | ×1 | 66 | 3 |
| Controlling High Blood Pressure (C14) | ×3 | 77 | 2 |
| Reducing the Risk of Falling (C15) | ×1 | 53 | 2 |
| Improving Bladder Control (C16) | ×1 | 56 | 5 |
| Plan All-Cause Readmissions (C17) | ×3 | 11 | 3 |
| Statin Therapy for Patients with Cardiovascular Disease (C18) | ×1 | 81 | 1 |
| Transitions of Care (C19) | ×1 | 41 | 2 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (C20) | ×1 | 62 | 2 |
| Getting Needed Care (C21) | ×2 | 81 | 3 |
| Getting Appointments and Care Quickly (C22) | ×2 | 84 | 4 |
| Customer Service (C23) | ×2 | 88 | 2 |
| Rating of Health Care Quality (C24) | ×2 | 86 | 3 |
| Rating of Health Plan (C25) | ×2 | 83 | 2 |
| Care Coordination (C26) | ×2 | 86 | 3 |
| Complaints about the Health Plan (C27) | ×2 | 0.18 | 4 |
| Members Choosing to Leave the Plan (C28) | ×2 | 27 | 3 |
| Health Plan Quality Improvement (C29) | ×5 | – | 2 |
| Plan Makes Timely Decisions about Appeals (C30) | ×2 | 98 | 4 |
| Reviewing Appeals Decisions (C31) | ×2 | 99 | 4 |
| Call Center - Foreign Language Interpreter and TTY Availability (C32) | ×2 | 100 | 5 |
| Call Center - Foreign Language Interpreter and TTY Availability (D01) | ×2 | 100 | 5 |
| Complaints about the Drug Plan (D02) | ×2 | 0.18 | 4 |
| Members Choosing to Leave the Plan (D03) | ×2 | 27 | 3 |
| Drug Plan Quality Improvement (D04) | ×5 | – | 3 |
| Rating of Drug Plan (D05) | ×2 | 84 | 2 |
| Getting Needed Prescription Drugs (D06) | ×2 | 88 | 2 |
| MPF Price Accuracy (D07) | ×1 | 100 | 5 |
| Medication Adherence for Diabetes Medications (D08) | ×3 | 87 | 2 |
| Medication Adherence for Hypertension (RAS antagonists) (D09) | ×3 | 89 | 3 |
| Medication Adherence for Cholesterol (Statins) (D10) | ×3 | 87 | 2 |
| Statin Use in Persons with Diabetes (SUPD) (D11) | ×1 | 84 | 2 |
| Concurrent Use of Opioids and Benzodiazepines (COB) (D12) | ×1 | 18 | 2 |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (D13) | ×1 | 4 | 5 |
Where H5434 has members
Florida (61,305)
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Other Guidewell Mutual Holding Corporation contracts
H1035 · Florida Blue HMO · 3.5 starsH4005 · Triple-S Advantage · 4.5 starsH5774 · Triple S Advantage · 5.0 starsH5938 · Capital Health Plan · 4.5 stars
Sources: CMS 2027 and 2026 Star Ratings data tables (CMS Part C and D performance data); CMS monthly enrollment by contract and county (October 2026). Sourced: CMS marks figures taken from CMS. Calculated marks figures Carelytics added up or compared. Built 2026-10-25.